Friday, October 05, 2007

Group Process

by Tory Butterworth

There's a lot of things that you need to learn to be a therapist. You need to be able to assess people as to the type of problem they have and how bad it is. You need to be able to find ways to talk to people about their problems that allow them to feel comfortable and safe enough to discuss the things they wouldn't outside the room, and yet not so comfortable that they never "get down to business." You need to have some sort of understanding of what makes people better, and the pitfalls which keep clients from getting there.

There are any number of different ways to do therapy, and different therapists do things quite differently. Yet, when I get together with a group of therapists, there does seem to be (at least) one commonality in all our differences. It's the concept of "process," that the way people act in a therapy session tells you as much about them as what they are saying ("content.")

I'm not just trained in the process of a one-on-one therapy session. My degree is in organizational psychology (read, "psychology of organizations," not "psychology of organizing things.") Because of this, I look at the way groups interact and decisions unfold in organizations. One of my client's used to talk about getting a, "bird's eye view" on life. That's the way I think of it: looking at the big picture of how things get done in an organization.

The therapists in the unit down the hall from my office are having some problems. There's a "partial hospitalization program" where patients come 3 to 6 days a week. The building just behind us houses a live-in "respite" program, for clients who need extra help to stay out of the hospital. Those clients live together and eat together, and come over as a group to attend the partial hospital program.

As you might imagine, the respite clients can change the process in the partial hospitalization program. Some days they make up half the people there. That's where I come in. I organized a role play with the staff on this unit, to give them the "feel" of how the group process has changed. I gave half of them a big green "D" to wear around their necks, and asked two of the supervisors to lead them in a group-building activity. The non-Ds I asked to stand out in the hall, and invited them back into the room one by one.

It was easy to create the phenomenon of feeling isolated as a non-D in the "D" group. It was so powerful, in fact, that when I reversed roles, asking the "D" group to stand out in the hall, the non-Ds weren't really able to coalesce as a group. A pretty powerful effect, to have occurred after 15 minutes of role play!

I've been thinking how designing role plays is similar to writing fiction. Most of us get our ideas, in one way or another, from real life, and we condense them into a plot and theme for our novel. Then, we have to figure out how to represent these ideas in the form of characters and action, to allow readers to feel the conflict, not just think about it. Sort of like how I created my role play, so the therapists could feel the group process, not just think about it.

How do you, as a writer, help readers feel your work?


Cathy said...

I try to write fiction that the reader can identify with, even if the situation may be new or unfamiliar. I use the six senses (no, I don't mean five) as much as I can and make the action as immediate as possible.

I'm having a conflict with the male therapist at work. He's there three of the four days I work at the Rivers Club. He has a definite attitude problem and can be downright strange and hurtful. I would like to develop some sort of role play so he can become accountable for his actions.

For instance, he takes things that aren't his. I'm thinking about leaving behind a bottle of oil with itching powder dissolved in it. Any ideas, Tory?

Tory said...

Cathy: If he takes soemthing of yours (e.g. some massage oil) you might go up to him calmly and ask for it back, e.g., "I think you borrowed some of my massage oil, could I have it back now?" If he's the big baby, and thinks you should provide for him, that's giving him the message that it's not your job. If he's the antisocial personality disorder, trying to get away with something, at least he knows you're watching him, and he may choose to steal from someone who's more oblivious.

Just my thought, based on never having met the guy (or ever wanting to.)

Alan Corn said...

Tory, with degrees in social work as well as sociology, my interest has always been in group dynamics. I have participated in many team building as well as role play activities. Over the years I have also conducted many of each. As you know, the underlying purpose of these activities is to have the participants EXPERIENCE something with others that they may not normally experience.

Not being a writer, I find your blog quite interesting. I never realized how writers do the same. Your goal is to have the reader experience what the characters are dealing with.

What a great blog!

Tory said...

Alan: Gee, thanks!

Glad to hear I have a compatriot in the group process work AND the mental health field.

Gina said...

Tory -
This is a hard post to respond to because I'm not sure I know how to make readers identify with my characters.

Cathy -
Wouldn't itching powder in the massage oil harm innocent massage recipients? You have to think of something that will only affect him. For example, I was living in a communal house at one time and one of the housemates was taking other people's food. She had money; she didn't have to steal to eat. She would just take other people's food and, if confronted, deny it, even if you caught her in the pantry with your bread in one hand and your open jar of jelly in the other (which I did once -- she said, "I'm not eating your food."). So someone (not me) came up with the idea of baking a chocolate cake with x-lax, then leaving it in the refrigerator with one slice already cut out, telling everyone not to eat it. Well, the cake began to disappear and the thief began to spend a lot of time in the bathroom . . .

Tory said...

Gina: That does sound satisfying, but did it stop her from stealing food?

Gina said...

Tory -
No, but it made everyone else feel better about it.
I'm not sure what would have made her stop. Maybe mousetraps in the breadbox? It wasn't possible to discuss it with her, since she denied doing it.

Nancy said...

Tory, this is fascinating, and has many applications in writing fiction. I'm also struck by the role POV plays. In your situation, every individual remains in their own POV, yet you, as the facilitator, must be aware of all POVs. (No wonder you're so perceptive!) I prefer to write in first person, so communcating how other characters think and feel is challenging. All thoughts and feelings must be processed via the single, POV character. (And therefore, that character becomes clearer and clearer to the writer as books progress.) But does working in first person make a writer into a self-centered SOB??

Tory said...

I prefer to think, Nancy, that writing in first person helps the writer become more aware of how people develop their impressions of others (and what they miss) and therefore makes one more sympathetic to our earthly limitations as human beings.

It definitely tickles me to think of myself as being "omniscient" during a role play. When we debrief it after, however, I'm mostly aware of how much is going on and how I can't possibly keep track of it all.

Cathy said...

My dad always used to talk about baking ex-lax cookies as punishment, so I found your cake laced with laxative very funny.

Thanks for the advice. I'll try confronting him calmly the next time. I may need more of your services in the future.